Operations – DUAL Program Management

Job not on LinkedIn

🔥 13 hours ago

🔔 Pennsylvania – Remote

🔔 Pennsylvania – Remote

💵 $75.4k - $199.1k / year

⏰ Full Time

🟠 Senior

🔴 Lead

📋 Program Manager

👻 Ghost score 0%

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• Open for 1 day.
• Jobs at this company usually fill in 21 days.

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CVS Health Careers

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛒 Retail

📦 Logistics

Healthcare • Retail • Logistics

CVS Health Careers is the recruitment and employer branding arm of CVS Health, showcasing job opportunities across the company's broad operations—pharmacy retail stores, pharmacy services, health care clinics, distribution warehouses, corporate functions and transportation. The careers site emphasizes purpose-driven work focused on improving access, affordability and quality of health care, and highlights a large workforce (300,000+ employees), inclusive culture, benefits, and hiring resources for applicants.

📋 Description

• Oversee day-to-day health plan operations across Integrated Plans • Ensure operational readiness, regulatory compliance, and execution of strategic initiatives • Coordinate operational oversight across health plan functional areas • Lead cross-functional efforts to identify, prioritize, and resolve operational issues • Establish and maintain readiness processes for product launches, benefit changes, regulatory requirements, and market expansions • Monitor operational performance, service levels, regulatory requirements, and business outcomes • Escalate risks and develop remediation strategies • Develop and maintain operational workplans, readiness trackers, risk logs, and reporting tools • Drive issue management, root-cause analysis, corrective actions, and prevention of future impacts • Partner with claims, enrollment, member services, care management, provider services, and compliance teams • Support state, CMS, NCQA, and internal audit activities through documentation, evidence collection, remediation planning, and progress reporting • Monitor regulatory changes and contract requirements for timely implementation and compliance • Develop executive-level reporting and presentations on performance, readiness, risks, issues, and mitigation plans • Serve as an operational subject matter expert and primary contact for Integrated Plan operations • Support financial remediation by identifying operational drivers and implementing corrective actions • Maintain relationships with market leaders, executive leadership, enterprise partners, regulators, and community stakeholders • Provide operational leadership during critical incidents, readiness events, and regulatory escalations • Support additional Health Plan Market Operations activities as business needs require

🎯 Requirements

• 7+ years of healthcare operations, managed care, health plan administration, regulatory compliance, or related experience • 5+ years of experience leading cross-functional operational initiatives and driving organizational outcomes • Experience supporting Dual Eligible Special Needs Plans (D-SNP), FIDE, HIDE, MLTSS • Strong knowledge of CMS, state regulatory requirements, health plan operations, and audit readiness processes • Experience developing executive-level reports, presentations, and operational performance dashboards • Ability to influence stakeholders and drive issue resolution without direct authority • Experience leading operational readiness, implementation, or transformation initiatives • Strong analytical, problem-solving, and decision-making skills • Excellent verbal, written, and presentation communication skills • Advanced proficiency in Microsoft Excel, PowerPoint, and data analysis tools • Bachelor's degree in Business Administration, Healthcare Administration, Public Health, Operations Management, or related field, or equivalent combination of education and experience • Qualified applicants with arrest or conviction records will be considered in accordance with federal, state, and local laws

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Paid time off • Retirement savings options • Wellness programs • Other resources supporting physical, emotional, and financial well-being • CVS Health bonus, commission or short-term incentive program • Equity award program

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